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PHARMACOLOGICAL ACTION The substance cyproterone acetate contained in Diane-35 blocks the effect of endogenously produced and exogenously administered androgens at the target organs by means of competitive inhibition. The stimulating effect of male sex hormones on androgen-dependent structures and functions is weakened or abolished by cyproterone acetate. Excessive sebaceous gland function is decreased. Apart from the described anti-androgen effect, cyproterone acetate also has a progestational action. The ethinylestradiol in the combination inhibits ovulation and changes the cervical mucus and the endometrium rendering them unfavourable for sperm penetration and nidation of a fertilised ovum, respectively. INDICATIONS Androgen-dependent acne, especially those forms which are accompanied by seborrhoea or by inflammation or formation of nodes (acne papulopustulosa, acne nodulocystica), androgen-dependent alopecia and mild forms of hirsutism. Oral contraception in women requiring anti-androgen therapy. Acne is a common skin condition that, more often than not, lowers the self-esteem of nearly 90 percent of adolescents, especially because it occurs on the face. Thus, people have been trying and testing a lot of treatments for acne, mostly to no avail. There are oral and topical medicines, as well as elective facial surgeries to treat the problem. In addition to the need to cure acne, young people also need to reduce the risk of unwanted pregnancy. Hence, there is now what we call a hybrid pill – both a contraceptive and acne pill. One concrete example of that is the Diane-35 (Dianette) Pill, manufactured by a well-known company, Schering. Now, Dianette may be marketed as a miraculous drug for teenagers, but it helps to really know the truths about it to see if it is the right medicine for you or your daughter. The formulation of Diane-35 includes cyproterone acetate (anti-androgen) and ethinylestradiol (estrogen) as its chief ingredients. Based on the British National Formulary, Diane-35 is nor more extraordinary than a standard oral, broad-spectrum antibiotic for acne. Nevertheless, it is useful for those who want an oral contraception and anti-acne pill in one taking. Diane-35 is specifically meant for women who suffer from acne and hirsutism (increased growth of facial/body hair) caused by overproduction of male hormone, androgen. Aside from that, Diane-35 helps treat acne by reducing the activity of the sebaceous gland. Noticeable effects can be seen after three to four months of therapy. However, Diane-35 should not be used by those who have thrombosis (blood clot), stroke, diabetes mellitus, jaundice, liver disease, liver tumour, and unexplained vaginal bleeding, as well as those who are pregnant and breastfeeding. How does Diane-35 work and what pharmaceutical group does it belong to? Diane-35 is a combined low-dose monophase oral hormonal contraceptive with antiandrogenic properties Contraceptive effect of Diane-35. Diane-35 inhibits ovulation and changes the viscosity of cervical mucus. Along with anti-androgenic properties, cyproterone has gestagen activity, simulating the properties of progesterone. Cyproterone inhibits the secretion of pituitary gonadotrophic hormones and inhibits ovulation. Ethinylestradiol increases central and peripheral effect of cyproterone on ovulation, retains a high viscosity of cervical mucus, making it difficult for sperm to penetrate the uterus and helps to ensure a reliable contraceptive effect. Which conditions are treated with Diane-35? Oral contraception in women with symptoms of androgenization Hirsutism (mild form) Androgenetical alopecia (hair loss) Acne vulgaris What should a patient know before using Diane-35? Diane-35 should not be used in cases of: Individual intolerance (including a history of hypersensitivity) to any component of Diane-35 Severe liver disorders and liver tumors Hereditary benign hyperbilirubinemia Diseases accompanied by disorders of hemostasis with a tendency to thrombosis, thromboembolic processes Diabetes mellitus with vascular complications (diabetic microangiopathy) Sickle-cell anemia Tumors of the breast and endometrium, hormone-dependent cancers Endometriosis Lipid metabolism disturbances, pancreatitis (including a history) accompanied by severe hypertriglyceridemia Idiopathic jaundice in pregnancy, severe itching or herpes of pregnant women in history Progressive otosclerosis occurred during pregnancy Vaginal / uterine bleeding of unknown etiology A history of migraine accompanied by focal neurological symptoms Suspected pregnancy, pregnancy and lactation Diane-35 Birth Control
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